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A study by scientists in a UK university has shown the scale of the prevalence of a condition that can lead to various cardiometabolic diseases. The study published in the Annals of Internal Medicine journal on Tuesday (January 4) has prompted calls for changes to healthcare policy after researchers revealed, for the first time, the scale of the impact of the condition associated with benign tumours that can lead to type 2 diabetes and high blood pressure. Up to 10 per cent of adults have a benign tumour, or lump, known as an 'adrenal incidentaloma' in their adrenal glands which can be associated with the overproduction of hormones including the stress steroid hormone cortisol that can lead to type 2 diabetes and high blood pressure. Previous small studies suggested that one in three adrenal incidentalomas produce excess cortisol, a condition called mild autonomous cortisol secretion (MACS). An international research team led by the University of Birmingham carried out the largest ever prospective study of over 1,305 patients with adrenal incidentalomas to assess their risk of high blood pressure and type 2 diabetes and their cortisol production by comparing patients with and without MACS.

One of the long-standing medical mysteries is the diagnosis of diabetes in majority of patients suffering from high blood pressure. The reason for this had been unknown. But now, an international team of universities have made a breakthrough. The research, published online in 'Circulation Research', involved contributions from collaborating scientists in Brazil, Germany, Lithuania, and Serbia, as well as the UK and New Zealand. The important new discovery has shown that a small protein cell glucagon-like peptide-1 (GLP-1) couples the body's control of blood sugar and blood pressure. Professor Julian Paton, a senior author, and director of Manaaki Manawa, The Centre for Heart Research at the University of Auckland, said: "We've known for a long time that hypertension and diabetes are inextricably linked and have finally discovered the reason, which will now inform new treatment strategies." GLP-1 is released from the wall of the gut after eating and acts to stimulate insulin from the pancreas to control blood sugar levels. This was known but what has now been unearthed is that GLP-1 also stimulates a small sensory organ called the carotid body located in the neck.

French drugmaker Sanofi will make 30 of its treatments, including insulin, available on a not-for-profit basis in 40 lower-income countries in the first step of its plan to increase access to its medicines worldwide. The treatments will be provided under the new Impact brand, part of Sanofi's global health unit launched last year, which sits outside the commercial business. The plan also includes the $25 million Impact fund, which will go towards supporting local start-up healthcare businesses and providing training on using the medicines, Sanofi said. "There's a lot of noise at the moment from different companies jumping into this space… but investing in entrepreneurship, in the ecosystem, is a new thing," said Jon Fairest, who heads the global health unit. The treatments available are on the World Health Organization's essential medicines list, and insulin in particular has been singled out by the UN agency as a life-saving medicine for diabetics that is difficult to access in many lower-income countries, where the burden of disease is growing.

Rachna Chhatralia, superintendent pharmacist at Day Lewis, has suggested that obesity should be a key focus area of the upcoming 10-year health plan. She advocated for a weight loss service to be commissioned through community pharmacies to address this growing public health issue effectively. "Obesity is a big problem in the UK, and it has progressively worsened as a result of COVID, with people being at home, unable to access gyms, and developing unhealthy eating habits," Rachna told Pharmacy Business. Rachna, the winner of the Pharmacy Business' Aspiring Pharmacy Leader of the Year, emphasised the urgent need to tackle obesity as it can lead to other long-term conditions in the long run and cost the NHS a lot of money. "If you don't try and tackle the obesity rate, you're then looking at treatment for other comorbidities, such as hypertension, diabetes, and cardiovascular issues, including heart attack and strokes. It just spirals out of control," she explained.